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General NPI Number Information
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NPI Number | 1225240153
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Entity Type | Individual
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Provider Name | SHELDON RAY WEINBERG PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 7721 MARYKNOLL AVE
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City | BETHESDA
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State | MD
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Zip | 20817-4828
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Country | US
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Telephone | 301-320-9008
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Fax |
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Provider Business Mailing Address
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Address Line | 7721 MARYKNOLL AVE
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City | BETHESDA
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State | MD
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Zip | 20817-4828
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Country | US
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Telephone | 301-320-9008
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0810002616
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 02759
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | 02759
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License Number State | MD
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